Adjusting for ACEs: services for rural children with Adverse Childhood Experiences

Ms Margaret Burgess1, Ms Jessica McGrath1, Dagney Hopp1

1Royal Far West, Manly, Australia


Studies have demonstrated a strong link between exposure to Adverse Childhood Experiences (ACEs) and poor health outcomes in adulthood. While there is growing evidence about the consequences of ACEs and the need for intervention, there is a need for further evidence on the prevalence of ACEs in rural and remote areas, including in Australia, and how interventions can be adapted for these rural and remote contexts.

Royal Far West (RFW) is an Australian charity based in Manly, New South Wales that has been providing paediatric and allied health services for children in rural and remote NSW for 94 years.

In 2017 RFW began a formal process of reorientating the organisation towards delivering care for families that recognizes the role of ACEs and traumatic experiences in child development. This process has included establishing an active working group to understand the prevalence of ACEs in our client population and to research and recommend ways to adjust practices within the organisation.

This work is now being used to inform RFW services and is also contributing to Royal Far West’s advocacy for increased investment nationally in understanding and reducing the impact of ACEs in rural and remote Australia.

Presenters will describe how learning more about this important area and the unique client population has led to key service changes and will share learnings about the change process.


Margaret Burgess is a Speech Pathologist working part time at the Royal Far West in Manly. She also works at the Dalwood Spilstead Service, an organisation providing intervention for children who have experienced early childhood trauma. Margaret studied at the National University of Ireland Galway and the University of Auckland before commencing work in Sydney in 2011. She has a strong focus on optimising the life outcomes of children who have experienced early childhood trauma. She is a member of the Northern Beaches Complex Trauma Network and is the Chair of the Royal Far West Trauma Working Party.

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